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Guides through decision to take antidepressants for depression. Covers symptoms of depression. Lists reasons for and against antidepressants. Covers side effects. Looks at other treatments to try. Includes interactive tool to help you make your decision.

Depression: Should I Take an Antidepressant?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Your options

If you're pregnant, there may be other issues that affect your decision. Pregnant women need to be more careful about taking
antidepressants.

Key points to remember

Taking medicine for your
depression can help you get your life back to normal,
especially if you also get counseling. But if your symptoms are mild, lifestyle
changes and counseling may be all you need.

You don't need to be
ashamed about taking antidepressants. Depression is a health problem, not a
character flaw or weakness. The medicines won't change your personality.

Antidepressants don't work right away. And you may need to try a
few before you find one that works.

Side effects are one reason
that people stop taking antidepressants. But talk to your doctor. There are
many ways to manage side effects. And lowering the dose or changing medicines
may also help.

The thought of needing to take medicine for a long
time can be scary. But many people are able to slowly stop taking
antidepressants after a while.

Most people are
able to find an antidepressant that helps their
depression. But you may have to try a few before you
find one that works for you. The right medicine is one that helps your symptoms
and has the fewest side effects.

You may start to feel better
within 1 to 3 weeks after you start taking an antidepressant. But you may need
to take it for as long as 6 to 8 weeks to see more improvement.

It's best to keep taking your medicine for at least 6 months after you
feel better. If this is not the first time you have been depressed, your doctor
may want you to take these medicines even longer.

The thought of
needing to take medicine for a long time can be scary. But many people are able
to slowly stop taking antidepressants after a while.

Antidepressants can change how you feel and respond in certain
situations, but they don't change who you are. You may feel more relaxed, more
social, more assertive, or more outgoing when you are taking an
antidepressant.

Depression treated only with antidepressants, and not also with therapy, is more likely to come back later.

Most
antidepressants cause minor side effects that go away or improve in the first
few weeks of treatment. If you keep taking your medicine, there is a good
chance that you will start to feel less depressed and that the side effects
will decrease. Most people feel that the benefits of antidepressants are well
worth the price of living with some side effects.

Side effects may
vary depending on the medicine you take, but common ones include:

Nausea.

Dry
mouth.

Loss of appetite.

Diarrhea or constipation.

Sexual problems (loss of desire, erection problems).

Headaches.

Trouble falling asleep, or waking a lot during the night.

Weight gain.

Feeling nervous or on edge.

Feeling drowsy in the daytime.

Some side effects may not go away, but usually there are
ways to manage them. Talk with your doctor about how to manage side effects.

Problems with sexual arousal and a lack of interest in
sex are common side effects. If this happens to you, talk to your doctor. There
are other medicines that may help with these problems.

Women who take an SSRI during pregnancy have a slightly higher chance of having a baby with birth defects. But not treating depression can also cause problems during pregnancy and birth. If you are pregnant, you and your doctor must weigh the risks of taking an SSRI against the risks of not treating depression.

The U.S. Food and Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. Talk to your doctor about these possible side effects and the warning signs of suicide.

Counseling

Counseling is an important part of the
treatment for depression. The types of counseling most often used for treatment
of depression include:

Cognitive-behavioral therapy, which teaches you how to
become healthier by changing certain thought and behavior
patterns.

Interpersonal therapy, which focuses on your relationships and the problems
they may be causing.

Problem-solving therapy, which focuses on the problems you are facing and on
helping you find solutions.

Family therapy, which involves the entire family.

Lifestyle changes

There are also lifestyle changes you may be able to make that may help
your depression symptoms:

Eat healthy foods.

Don't
drink alcohol.

Get regular exercise.

Get a good night's sleep.

Get social
support from family and friends.

Try to keep a positive
attitude—remember that feeling better takes time, and your mood will improve
little by little.

Other treatment choices

Besides counseling and lifestyle changes, there are some other treatments
you can try:

Alternative treatments such as
massage therapy and
yoga may help you get better faster and make your life
better.

You can try
relaxation exercises at home to lower your stress.

The herb
St. John's wort may help if you have mild depression. But it can cause
problems with other medicines you may be taking, so talk to your doctor before
you try this herb.

Electroconvulsive therapy may be used to treat severe
depression or depression that hasn't responded well to other treatment. It also
may be a treatment choice for someone who cannot live with the side effects of
antidepressants.

You have tried counseling and lifestyle
changes, and they haven't worked.

Your symptoms are bad enough that
they interfere with your daily life.

Compare your options

Compare

What is usually involved?

What are the benefits?

What are the risks and side effects?

Take antidepressants
Take antidepressants

You take a pill or liquid
medicine one or more times a day for months or sometimes years.

Antidepressants can improve
or completely relieve symptoms.

Antidepressants usually help when
counseling and lifestyle changes haven't worked.

It takes
weeks, and sometimes months, for the medicine to start working.

You
may have to keep taking antidepressants for a long time.

Side
effects—which can include nausea, diarrhea or constipation, sexual problems,
weight gain, and trouble sleeping—cause many people to stop taking the
medicine.

Don't take
antidepressants Don't take
antidepressants

You treat your
depression with counseling, such as cognitive-behavioral therapy (CBT) or interpersonal psychotherapy (IPT). Many studies show that CBT helps mild to moderate depression as much as antidepressants.1 You can also help your depression with support and lifestyle changes, such as exercise.

You may try
alternative treatments, such as massage and relaxation techniques.

Counseling works well
for many people who have depression. Studies show that people who receive CBT have lower rates of relapse after treatment has stopped compared to people treated only with antidepressants.2

You avoid the side
effects of the medicine.

Counseling may not be enough if your symptoms
are severe.

Untreated depression is likely to get worse.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

Personal stories about deciding whether to take antidepressants

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I didn't
even realize that I was depressed for a long time. I thought everyone felt this
way; at least everyone in my family seemed to. I probably would have just gone
on like that if my doctor hadn't asked one day if I had ever thought about taking
an antidepressant. I was relieved to find out that it isn't normal to feel like
I do and that a lot of people are helped by medicines. I know it might take a
while to find the right one, but I'm in no hurry; I've spent my whole life
feeling sad.

Jackie,
age 62

I tried antidepressants about a year ago. I
really was not prepared for the first few weeks, when the side effects seemed
to get me down even more than the depression did. So I stopped taking them. It
took me about 3 months, but I eventually started to feel better without any
medicine. Then last month, I started to feel depressed again. I don't want to
wait so long to feel better this time. So I'm going to try the antidepressants
again. This time, I know what to expect and am better prepared for it.

Tyrone, age
43

I guess I'm just not comfortable with
taking medicine for my depression. I feel like I ought to be able to manage
this on my own without needing medicine. It seems too much like taking the
easy route. But maybe I just don't feel bad enough yet.

Bob, age 50

I recently began going to counseling. I
know that if I took an antidepressant, I might feel better sooner, but I don't
like the sound of the side effects I could have. My therapist and I have set
some goals for me to work on, and we agreed to revisit my decision in 3 months.
I want to wait and see how the counseling goes before I take medicine.

Joslyn, age
28

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take antidepressants

Reasons not to take antidepressants

My symptoms are keeping me from living my normal life.

My symptoms aren't bad enough to get in the way of my life.

More important

Equally important

More important

I'm willing to take medicine every day for at least 6 months, and maybe longer.

I don't like the idea of taking medicine for a long time.

More important

Equally important

More important

My symptoms are worse than the possible side effects of the medicines.

I think the side effects will be worse than my symptoms.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking an antidepressant

NOT taking an antidepressant

Leaning toward

Undecided

Leaning toward

What else do you need to make your decision?

Check the facts

1.

Are antidepressants right for everyone with depression?

YesSorry, that's wrong. Taking medicine for your depression can help you get your life back to normal. But if your symptoms are mild, lifestyle changes and counseling may be all you need.

NoYou're right. Taking medicine for your depression can help you get your life back to normal. But if your symptoms are mild, lifestyle changes and counseling may be all you need.

I'm not sureIt may help to go back and read "Get the Facts." Taking medicine for your depression can help you get your life back to normal. But if your symptoms are mild, lifestyle changes and counseling may be all you need.

2.

Is it possible to manage the side effects of antidepressants?

YesThat's right. There are many ways to manage the side effects of antidepressants. If you're worried, talk to your doctor.

NoSorry, that's wrong. There are many ways to manage the side effects of antidepressants. If you're worried, talk to your doctor.

I'm not sureIt may help to go back and read "Get the Facts." There are many ways to manage the side effects of antidepressants. If you're worried, talk to your doctor.

3.

Will you start to feel better right away?

YesNo, that's wrong. Antidepressants don't work right away. And you may need to try several before you find one that works.

NoThat's right. Antidepressants don't work right away. And you may need to try several before you find one that works.

I'm not sureIt may help to go back and read "Get the Facts." Antidepressants don't work right away. And you may need to try several before you find one that works.

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Depression: Should I Take an Antidepressant?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Get the facts

Compare your options

What matters most to you?

Where are you leaning now?

What else do you need to make your decision?

1. Get the Facts

Your options

Take antidepressants to treat
depression.

Don't take antidepressants.

If you're pregnant, there may be other issues that affect your decision. Pregnant women need to be more careful about taking
antidepressants.

Key points to remember

Taking medicine for your
depression can help you get your life back to normal,
especially if you also get counseling. But if your symptoms are mild, lifestyle
changes and counseling may be all you need.

You don't need to be
ashamed about taking antidepressants. Depression is a health problem, not a
character flaw or weakness. The medicines won't change your personality.

Antidepressants don't work right away. And you may need to try a
few before you find one that works.

Side effects are one reason
that people stop taking antidepressants. But talk to your doctor. There are
many ways to manage side effects. And lowering the dose or changing medicines
may also help.

The thought of needing to take medicine for a long
time can be scary. But many people are able to slowly stop taking
antidepressants after a while.

FAQs

Are you depressed?

The symptoms of
depression include a loss of interest in daily
activities or feeling sad or hopeless and having at least four of the following
symptoms:

A change in eating patterns that causes
either weight gain or weight loss

Sleeping too much or not
enough

Feeling restless and unable to sit still, or feeling that
moving takes a great effort

Feeling tired all the
time

Feeling unworthy or guilty without an obvious
reason

Having problems concentrating, remembering, or making
decisions

Thinking often about death or suicide

What are antidepressants?

Antidepressants are
medicines for treating
depression. They work by helping to balance certain
chemicals in your brain. They can make your symptoms better or get rid of them
completely.

There are several kinds of antidepressants. There is
no evidence that one works better than another. But the side effects are
different.

You don't need to be
ashamed about taking antidepressants. Depression is a health problem, not a
character flaw or weakness.

How well do antidepressants work?

Most people are
able to find an antidepressant that helps their
depression. But you may have to try a few before you
find one that works for you. The right medicine is one that helps your symptoms
and has the fewest side effects.

You may start to feel better
within 1 to 3 weeks after you start taking an antidepressant. But you may need
to take it for as long as 6 to 8 weeks to see more improvement.

It's best to keep taking your medicine for at least 6 months after you
feel better. If this is not the first time you have been depressed, your doctor
may want you to take these medicines even longer.

The thought of
needing to take medicine for a long time can be scary. But many people are able
to slowly stop taking antidepressants after a while.

Antidepressants can change how you feel and respond in certain
situations, but they don't change who you are. You may feel more relaxed, more
social, more assertive, or more outgoing when you are taking an
antidepressant.

Depression treated only with antidepressants, and not also with therapy, is more likely to come back later.

What side effects can antidepressants cause?

Most
antidepressants cause minor side effects that go away or improve in the first
few weeks of treatment. If you keep taking your medicine, there is a good
chance that you will start to feel less depressed and that the side effects
will decrease. Most people feel that the benefits of antidepressants are well
worth the price of living with some side effects.

Side effects may
vary depending on the medicine you take, but common ones include:

Nausea.

Dry
mouth.

Loss of appetite.

Diarrhea or constipation.

Sexual problems (loss of desire, erection problems).

Headaches.

Trouble falling asleep, or waking a lot during the night.

Weight gain.

Feeling nervous or on edge.

Feeling drowsy in the daytime.

Some side effects may not go away, but usually there are
ways to manage them. Talk with your doctor about how to manage side effects.

Problems with sexual arousal and a lack of interest in
sex are common side effects. If this happens to you, talk to your doctor. There
are other medicines that may help with these problems.

Women who take an SSRI during pregnancy have a slightly higher chance of having a baby with birth defects. But not treating depression can also cause problems during pregnancy and birth. If you are pregnant, you and your doctor must weigh the risks of taking an SSRI against the risks of not treating depression.

The U.S. Food and Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. Talk to your doctor about these possible side effects and the warning signs of suicide.

What are other treatments for depression?

Counseling

Counseling is an important part of the
treatment for depression. The types of counseling most often used for treatment
of depression include:

Cognitive-behavioral therapy, which teaches you how to
become healthier by changing certain thought and behavior
patterns.

Interpersonal therapy, which focuses on your relationships and the problems
they may be causing.

Problem-solving therapy, which focuses on the problems you are facing and on
helping you find solutions.

Family therapy, which involves the entire family.

Lifestyle changes

There are also lifestyle changes you may be able to make that may help
your depression symptoms:

Eat healthy foods.

Don't
drink alcohol.

Get regular exercise.

Get a good night's sleep.

Get social
support from family and friends.

Try to keep a positive
attitude—remember that feeling better takes time, and your mood will improve
little by little.

Other treatment choices

Besides counseling and lifestyle changes, there are some other treatments
you can try:

Alternative treatments such as
massage therapy and
yoga may help you get better faster and make your life
better.

You can try
relaxation exercises at home to lower your stress.

The herb
St. John's wort may help if you have mild depression. But it can cause
problems with other medicines you may be taking, so talk to your doctor before
you try this herb.

Electroconvulsive therapy may be used to treat severe
depression or depression that hasn't responded well to other treatment. It also
may be a treatment choice for someone who cannot live with the side effects of
antidepressants.

Why might your doctor recommend antidepressants?

Your doctor might suggest that you try antidepressants if:

You have tried counseling and lifestyle
changes, and they haven't worked.

Your symptoms are bad enough that
they interfere with your daily life.

2. Compare your options

Take antidepressants

Don't take
antidepressants

What is usually involved?

You take a pill or liquid
medicine one or more times a day for months or sometimes years.

You treat your
depression with counseling, such as cognitive-behavioral therapy (CBT) or interpersonal psychotherapy (IPT). Many studies show that CBT helps mild to moderate depression as much as antidepressants.1 You can also help your depression with support and lifestyle changes, such as exercise.

You may try
alternative treatments, such as massage and relaxation techniques.

What are the benefits?

Antidepressants can improve
or completely relieve symptoms.

Antidepressants usually help when
counseling and lifestyle changes haven't worked.

Counseling works well
for many people who have depression. Studies show that people who receive CBT have lower rates of relapse after treatment has stopped compared to people treated only with antidepressants.2

You avoid the side
effects of the medicine.

What are the risks and side effects?

It takes
weeks, and sometimes months, for the medicine to start working.

You
may have to keep taking antidepressants for a long time.

Side
effects—which can include nausea, diarrhea or constipation, sexual problems,
weight gain, and trouble sleeping—cause many people to stop taking the
medicine.

Counseling may not be enough if your symptoms
are severe.

Untreated depression is likely to get worse.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These
personal stories
may help you decide.

Personal stories about deciding whether to take antidepressants

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"I didn't even realize that I was depressed for a long time. I thought everyone felt this way; at least everyone in my family seemed to. I probably would have just gone on like that if my doctor hadn't asked one day if I had ever thought about taking an antidepressant. I was relieved to find out that it isn't normal to feel like I do and that a lot of people are helped by medicines. I know it might take a while to find the right one, but I'm in no hurry; I've spent my whole life feeling sad."

— Jackie,
age 62

"I tried antidepressants about a year ago. I really was not prepared for the first few weeks, when the side effects seemed to get me down even more than the depression did. So I stopped taking them. It took me about 3 months, but I eventually started to feel better without any medicine. Then last month, I started to feel depressed again. I don't want to wait so long to feel better this time. So I'm going to try the antidepressants again. This time, I know what to expect and am better prepared for it."

— Tyrone, age
43

"I guess I'm just not comfortable with taking medicine for my depression. I feel like I ought to be able to manage this on my own without needing medicine. It seems too much like taking the easy route. But maybe I just don't feel bad enough yet."

— Bob, age 50

"I recently began going to counseling. I know that if I took an antidepressant, I might feel better sooner, but I don't like the sound of the side effects I could have. My therapist and I have set some goals for me to work on, and we agreed to revisit my decision in 3 months. I want to wait and see how the counseling goes before I take medicine."

— Joslyn, age
28

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take antidepressants

Reasons not to take antidepressants

My symptoms are keeping me from living my normal life.

My symptoms aren't bad enough to get in the way of my life.

More important

Equally important

More important

I'm willing to take medicine every day for at least 6 months, and maybe longer.

I don't like the idea of taking medicine for a long time.

More important

Equally important

More important

My symptoms are worse than the possible side effects of the medicines.

I think the side effects will be worse than my symptoms.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking an antidepressant

NOT taking an antidepressant

Leaning toward

Undecided

Leaning toward

5. What else do you need to make your decision?

Check the facts

1.
Are antidepressants right for everyone with depression?

Yes

No

I'm not sure

You're right. Taking medicine for your depression can help you get your life back to normal. But if your symptoms are mild, lifestyle changes and counseling may be all you need.

2.
Is it possible to manage the side effects of antidepressants?

Yes

No

I'm not sure

That's right. There are many ways to manage the side effects of antidepressants. If you're worried, talk to your doctor.

3.
Will you start to feel better right away?

Yes

No

I'm not sure

That's right. Antidepressants don't work right away. And you may need to try several before you find one that works.

Decide what's next

1.
Do you understand the options available to you?

Yes

No

2.
Are you clear about which benefits and side effects matter most to you?

Yes

No

3.
Do you have enough support and advice from others to make a choice?

Yes

No

Certainty

1.
How sure do you feel right now about your decision?

Not sure at all

Somewhat sure

Very sure

2.
Check what you need to do before you make this decision.

I'm ready to take action.

I want to discuss the options with others.

I want to learn more about my options.

3.
Use the following space to list questions, concerns, and next steps.

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